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Sex Workers, Empowerment and Poverty Alleviation in Ethiopia

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Sex Workers, Empowerment and Poverty Alleviation in Ethiopia EVIDENCE REPORT No 80 IDSSexuality, Poverty and Law Sex Workers, Empowerment and Poverty Alleviation in Ethiopia Cheryl Overs June 2014 The IDS programme on Strengthening Evidence-based Policy works across seven key themes. Each theme works with partner institutions to co-construct policy-relevant knowledge and engage in policy-influencing processes. This material has been developed under the Sexuality, Poverty and Law theme. The material has been funded by UK aid from the UK Government, however the views expressed do not necessarily reflect the UK Government’s official policies. AG Level 2 Output ID: 232 SEX WORKERS, EMPOWERMENT AND POVERTY ALLEVIATION IN ETHIOPIA Cheryl Overs June 2014 This is an Open Access publication distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are clearly credited. First published by the Institute of Development Studies in June 2014 © Institute of Development Studies 2014 IDS is a charitable company limited by guarantee and registered in England (No. 877338). Contents Abbreviations and terms 3 Acknowledgements 3 Executive summary 4 1 The global context: poverty and sex work 6 2 The Ethiopian context 9 2.1 Economics and policies 9 2.2 Ethiopia’s legal system 10 2.3 HIV and AIDS 11 2.4 Civil society 11 3 Case study methodology 13 3.1 Limitations 13 4 Sex work in Ethiopia 15 4.1 Types of sex work 15 4.2 Economic policy and programmes for sex workers 15 4.2.1 Traditional associations 16 4.2.2 Faith-based organisations 16 4.2.3 HIV prevention and care programmes that target sex workers 16 4.3 Sex work and HIV 17 5 Information from sex workers 18 5.1 Law and policy 18 5.2 Violence and exploitation 19 5.3 Poverty and poverty alleviation 20 5.4 Health care 22 6 Discussion: the impact of policy, law and poverty on sex workers’ lives and livelihoods 23 6.1 Criminal law 23 6.2 Citizenship 24 6.3 Poverty alleviation programmes 25 7 Economic empowerment of sex workers: a risky but worthwhile business 28 7.1 Addressing complex interactions of poverty, choice, risk and circumstances 28 7.2 Pathways, roadblocks and wrong turns on the road to economic empowerment of sex workers 28 7.3 Lessons from successes and failures 29 7.4 Learning lessons, gathering evidence and building a community of practice 31 8 Recommendations 36 8.1 International 36 8.1.1 Map and evaluate economic existing empowerment policies and programmes for sex workers 36 8.1.2 Document evidence and develop a conceptual framework 36 8.1.3 Delineate sex work and trafficking 36 8.1.4 Identify structural determinants of poverty and develop policy to minimise them 36 1 8.1.5 Improve needs assessment tools 36 8.1.6 Ensure programme viability and scale 36 8.1.7 Improve planning and evaluation tools 37 8.1.8 Clarify HIV prevention and care goals 37 8.1.9 Observe and prevent harm 38 8.2 Ethiopia 38 8.2.1 Law 38 8.2.2 Policy 38 8.2.3 Programming 38 References 40 Boxes Box 1.1 Sex work, sex trafficking and sexual exploitation: different philosophies, different strategies 7 Box 1.2 Aims of economic empowerment programmes at a glance 8 Box 3.1 The sites 14 Box 5.1 Mobilising for safety and rights in Bahir Dar 19 Box 6.1 Having ‘the right papers’: a structural determinant of sex workers’ poverty 25 Box 6.2 Why economic initiatives for sex workers fail: key findings 27 Box 7.1 Economic empowerment – a risky business 30 2 Abbreviations and terms ART Antiretroviral therapy ARV Antiretroviral CEDAW Convention on Ending Discrimination against Women CPU Child Protection Unit EEP Economic empowerment programmes FDRE Federal Democratic Republic of Ethiopia FGM female genital mutilation FHAPCO Federal HIV/AIDS Prevention and Control Office HEP Health Extension Programme Idir/iqub Informal community-based organisations IGA income generating activity Kabele/woreda Local government bodies in Ethiopia NGO Non-Governmental Organisations Nikat Nikat Women’s Association is an Ethiopian NGO established by sex workers NPUD National Policy on Urban Development PEPFAR US President's Emergency Fund for AIDS Relief RPAR Rapid Policy Assessment and Response STI sexually transmitted infection Timret Timret Lehiwot Ethiopia is an HIV/AIDS NGO based in Addis Ababa UN United Nations UNFPA United Nations Population Fund VEWEP Vulnerable Women Empowerment Program Wise Up National HIV prevention programme operated by US company DKT Acknowledgements The author would like to acknowledge the invaluable contributions of the women of Nikat, Beza Alemehayu, Henock Alemehayu, Associate Professor Bebe Loff, Nicholas Moody, Cassandra Van and Michael Williams. The author would also like to thank Timret Lehiwot, Vamp, Wise Up and Women’s Network for Unity for permission to use their photographs. 3 Executive summary This case study explores economic, legal and social issues that affect sex workers, with a particular focus on the role of poverty in sex workers’ lives and the potential for poverty alleviation policies and programmes to help lift as many sex workers as possible out of poverty in order to reduce the exploitation, illness and violence associated with their work. In surveys, sex workers overwhelmingly indicate they would like another occupation, particularly in very poor countries. This has been taken to mean that relieving the poverty of individual sex workers will lead them to stop or reduce sex work. On this analysis, reduced poverty will mean that the number of women entering the sex industry, or staying in it, will be reduced and/or that the harm associated with sex work would be diminished because the numbers of partners or of unprotected sexual contacts would reduce. However, the validity of this logic and the benefits, costs and consequences (intended and unintended) of poverty alleviation in the context of sex work have not been tested or even well documented. Drawing on relevant international literature and field work conducted in three sites in Ethiopia, various types of economic empowerment programmes (EEPs) and policies were studied including income generating activities, social enterprise, microfinance, life skills and vocational training, buyers’ clubs as well as credit cooperatives and revolving welfare funds operated by governments, churches, public health agencies and sex worker communities. Information about the EEPs and policies available is limited and no conceptual frameworks, overviews of policies or clear maps of how and where programmes operate and what outcomes they achieve have emerged. In the absence of such information, technical guidance, evaluation protocols or even accounts of best practice are also unavailable. Because successes, suboptimal outcomes and failures of policies and programmes are not well understood, opportunities to improve and expand them are missed and human rights abuses and other adverse consequences are not observed and documented. This study addresses this dearth of policy guidance by providing empirical evidence and a corresponding set of policy recommendations at an international and national level to ensure that development programmes address poverty for all affected population groups, with a focus on sex work in Ethiopia. Although adult sex work is illegal in Ethiopia the law is not enforced and sex workers are not subject to the levels of violence and extortion by police that have been widely reported in other countries. Further, although poverty and poor labour conditions for women clearly incentivise women and girls to sell sex, sex work does not in most cases provide a way out of acute poverty in Ethiopia. Since 2012 the Federal Democratic Republic of Ethiopia’s (FDRE) policy on poverty alleviation has included sex workers. It funds traditional EEPs operated at a local level and allows HIV programmes and faith-based non-governmental organisations (NGOs) to operate EEPs in conjunction with other services, although their purpose is not articulated. On the other hand, the economic vulnerability that drives women into sex work and renders them liable to exploitation and abuse is made worse by policy that deprives women of legal recognition and therefore access to employment, education resources and services. Government policy also limits civil society engagement in advocacy, reduces the potential for sex workers to mobilise and obstructs institutional opportunities to address social, legal and economic issues around sex work. Although the outcomes of the various EEPs for sex workers operating in Ethiopia are not reported, there is anecdotal evidence that they enhance sex workers’ livelihoods and form an 4 important gateway to accessing services and building social support networks. However, it is clear that the policy and the programmes do not lead to enough women leaving sex work to reduce the size of the industry and therefore the problems associated with it. There are a number of possible explanations for this, including: that places in EEPs are limited; that the enterprises the sex workers undertake lack viability; that EEPs do not provide sustainable, living wages; that programmes stigmatise women; and that collective economic activity may not be suited to communities characterised by mobility and lack of social cohesion. The case study concludes with recommendations for Ethiopia and other countries. Primary among these is the need for a conceptual framework upon which to build policy and programming for economic empowerment. Such a framework should be grounded in human rights and cognisant of diverse aspirations and attitudes among sex workers of different backgrounds, and it should be based on a clear delineation between adult sex work, human trafficking and abuse of minors. Research to produce knowledge about EEPs is urgently needed in order to learn lessons about how to develop, target, and monitor policies and programmes that are ethical, effective and large enough to matter.
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